Title
Effect of oral contraceptives on haemostasis variables
Author
Kluft, C.
Lansink, M.
Gaubius Instituut TNO
Publication year
1997
Abstract
Combined oral contraceptives (COCs) have effects on a large number of haemostasis variables. We have summarised literature data on effects of COCs containing 30-35 μg ethinyl estradiol for the third generation of progestogens (PGs): desogestrel, gestodene and norgestimate. It is concluded that about 15 variables show a shift in distribution of the order of magnitude of their interindividual variation coefficient. When comparing the third generation of PGs with the second one (norgestrel, levonorgestrel) stronger increases are noted for the former for some haemostatic variables. Also differences between desogestrel and gestodene for factor VII were apparent. It indicates that the role of PGs in the effects of COCs is significant and their design may in addition to reduction of oestrogen dosage be important in reducing haemostatic complications. The survey on molecular and cellular mechanisms by which the sex steroids might operate showed a great lack of knowledge. Only for factor XII has a functional oestrogen response element in the DNA definitely been identified. The study of molecular markers of coagulation and fibrinolysis have shown a distinct increased activation of coagulation (F 1+2, FPA) and fibrinolysis (PAP), and an increased fibrin turn-over (increased FDPs); platelet products are not found increased (βTG, PF-4). The increase in fibrinolysis represent a counterforce, but individual changes in variables in coagulation and fibrinolysis do not correlate indicating independent effects and no evidence for a individually regulated balance. A first step in further research might be in understanding the increase in coagulation activation (F 1+2) which has so far not been satisfactorily related to changes in blood concentrations of haemostatic factors and possibly local factors. Copyright © 1997 Schattauer Verlag
Subject
Biology
Biology
Blood Coagulation Effects
Blood Proteins
Cardiovascular Effects
Contraception
Contraceptive Agents
Contraceptive Agents, Female
Contraceptive Agents, Progestin
Contraceptive Methods
Contraceptive Mode Of Action
Developed Countries
Diseases
Europe
Family Planning
Heart Diseases
Hematological Effects
Hemic System
Literature Review
Netherlands
Oral Contraceptives
Oral Contraceptives, Combined
Oral Contraceptives, Low-dose
Physiology
Vascular Diseases
Western Europe
Biological Markers
Blood Coagulation
Contraceptives, Oral, Combined
Dose-Response Relationship, Drug
Ethinyl Estradiol
Fibrinolysis
Hemostasis
Humans
Progestins
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http://resolver.tudelft.nl/uuid:048b3f48-c687-4c67-8cdf-a9d6aafe5518
DOI
https://doi.org/10.1055/s-0038-1657546
TNO identifier
233964
ISSN
0340-6245
Source
Thrombosis and Haemostasis, 78 (1), 315-326
Document type
article